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<!DOCTYPE html>
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<title>ESS | Investment Declaration</title>
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<div class="d-none d-md-block d-lg-block"><h4>VNR Seeds Private Limited India</h4></div>
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<h4>Rohit Kumar</h4>
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<p>Emp. Code - 1254</p>
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<td >1.</td>
<td ><b>Ledger 2023-24</b></td>
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<h4 class="text-center">Investment Declaration Form 2023-2024</h4>
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<ul class="user-details">
<li>Employee ID: 1254</li>
<li>Employee Name: Rohit Kumar</li>
<li>PAN Number: ADT12548RH</li>
<li>Company Name: VNR SEEDS PVT. LTD.</li>
</ul>
<br>
<p><b>Please remember the following points while filling up the form</b></p>
<ol style="color: #686464;">
<li>Do not forget to mention you Employee Id , Name & Pan card .</li>
<li>Only Submission Amount needs to be filled. Do not change the figures mentioned in Max. limit Column.</li>
<li> You are requested to submit the required proofs up to last date of submission, failing which will be assumed that the employee does not have any Tax </li>
<li>Saving and income other than salary, and the Income Tax will be recomputed and tax will be deducted accordingly.</li>
</ol>
<p><b>(To be used to declare investment for income Tax that will be made during the period )</b></p><br>
<p><b>Deduction Under Section 10</b></p>
<table class="table table-bordered table-striped">
<thead>
<tr>
<th style="width: 10%;">Item</th>
<th>Particulars</th>
<th style="width: 7%;">Max. Limit</th>
<th style="width: 14%;">Declared Amount</th>
</tr>
</thead>
<tbody>
<tr>
<td>House Rent Sec 10(13A)</td>
<td>I am staying in a house and I agree to submit rent receipts when required. The Rent paid is (Rs._______ Per Month) & the house is located in Non-Metro</td>
<td></td>
<td><input type="text"></td>
</tr>
<tr>
<td>LTA Sec 10(5)</td>
<td>I will provide the tickets/ Travels bills in original as per(one basic annually) the LTA policy or else the company can consider amount as taxable.</td>
<td><b>16000/-</b> <input style="float:right;height: 15px;" type="checkbox"></td>
<td><input type="text"></td>
</tr>
<tr>
<td>CEA Sec 10(14)</td>
<td>I will provide the copy of tuition fees receipt as per CEA policy or else the company can consider amount as taxable.(Rs100/- per month per child up to max of two children)</td>
<td><b>2400/-</b> <br>Child-1 <input style="float:right;height: 15px;" type="checkbox"> Child-2 <input style="float:right;height: 15px;" type="checkbox"></td>
<td><input type="text"></td>
</tr>
</tbody>
</table>
<p style="color: #686464;">** If you have opted for the medical reimbursements ( being Medical expenses part of your CTC)</p>
<br>
<table class="table table-bordered table-striped">
<thead>
<tr>
<th style="width: 10%;">Item</th>
<th>Particulars</th>
<th style="width: 7%;">Max. Limit</th>
<th style="width: 14%;">Declared Amount</th>
</tr>
</thead>
<tbody>
<tr>
<td>Deductions Under Chapter VI A</td>
<td>Sec.80D - Medical Insurance Premium (If the policy covers a senior Citizen then additional deduction of Rs.5000/- is available & deduction on account of expenditure on preventive Health Check-Up (for Self, Spouse, Dependant Children & Parents )Shall not exceed in the aggregate Rs 5000/-.)</td>
<td><b>25000/-</b></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>"Sec. 80DD - Medical treatment/insurance of Handicapped Dependant A higher deduction of Rs. 100,000 is available, where such dependent is with severe disability of > 80%"</td>
<td><b>50000/-</b></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>"Sec 80DDB - Medical treatment (specified diseases only) (medical treatment in respect of a senior Citizen then additional deduction of Rs.20,000/- is available)"</td>
<td><b>40000/-</b></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>Sec 80E - Repayment of Loan for higher education (only interest)</td>
<td>-</td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>Sec 80U - Handicapped</td>
<td><b>50000/-</b></td>
<td><input type="text"></td>
</tr>
</tbody>
</table>
<table class="table table-bordered table-striped">
<thead>
<tr>
<th style="width: 10%;">Item</th>
<th>Particulars</th>
<th style="width: 7%;">Max. Limit</th>
<th style="width: 14%;">Declared Amount</th>
</tr>
</thead>
<tbody>
<tr>
<td>Deduction Under Section 80C</td>
<td>Sec 80CCC - Contribution to Pension Fund (Jeevan Suraksha)</td>
<td><b>25000/-</b></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>Life Insurance Premium</td>
<td></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>Deferred Annuity</td>
<td></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>Public Provident Fund</td>
<td></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>Time Deposit in Post Office / Bank for 5 year & above</td>
<td></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>ULIP of UTI/LIC</td>
<td></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>Principal Loan (Housing Loan) Repayment</td>
<td></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>Mutual Funds</td>
<td></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>Investment in infrastructure Bonds</td>
<td></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>Children- Tuitions Fee restricted to max. of 2 children</td>
<td></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>Deposit in NHB</td>
<td></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>Deposit In NSC</td>
<td></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>Sukanya Samriddhi</td>
<td></td>
<td><input type="text"></td>
</tr>
<tr>
<td></td>
<td>Others (please specify) Employee Provident Fund</td>
<td></td>
<td><input type="text"></td>
</tr>
</tbody>
</table>
<p><b>Declaration:</b></p>
<ol><li>I hereby declare that the information given above is correct and true in all respects.</li>
<li>I also undertake to indemnify the company for any loss/liability that may arise in the event of the above information being incorrect.</li>
</ol>
<div class="row">
<div class="col-md-12 mt-4 mb-3">
<div class="float-start">
<b>Date:</b> 15 Feb 2024<br> <br><b>Place:</b> Raipur
</div>
<div class="float-end mt-3">
<b>Signature</b>
</div>
</div>
</div>
</div>
<div class="tab-pane fade" id="newregime" role="tabpanel">
<ul class="user-details">
<li>Employee ID: 1254</li>
<li>Employee Name: Rohit Kumar</li>
<li>PAN Number: ADT12548RH</li>
<li>Company Name: VNR SEEDS PVT. LTD.</li>
</ul>
<br>
<p><b>Please remember the following points while filling up the form</b></p>
<ol style="color: #686464;">
<li>Do not forget to mention you Employee Id , Name & Pan card .</li>
<li>Only Submission Amount needs to be filled. Do not change the figures mentioned in Max. limit Column.</li>
<li> You are requested to submit the required proofs up to last date of submission, failing which will be assumed that the employee does not have any Tax </li>
<li>Saving and income other than salary, and the Income Tax will be recomputed and tax will be deducted accordingly.</li>
</ol>
<p><b>(To be used to declare investment for income Tax that will be made during the period )</b></p><br>
<p><b>Deduction Under Section 10</b></p>
<table class="table table-bordered table-striped">
<thead>
<tr>
<th style="width: 10%;">Item</th>
<th>Particulars</th>
<th style="width: 7%;">Max. Limit</th>
<th style="width: 14%;">Declared Amount</th>
</tr>
</thead>
<tbody>
<tr>
<td>Sec. 80CCD(2)</td>
<td>Corporate NPS Scheme</td>
<td>10% Of Basic Salary</td>
<td><input type="text"></td>
</tr>
</tbody>
</table>
<p><b>Declaration:</b></p>
<ol><li>I hereby declare that the information given above is correct and true in all respects.</li>
<li>I also undertake to indemnify the company for any loss/liability that may arise in the event of the above information being incorrect.</li>
</ol>
<div class="row">
<div class="col-md-12 mt-4 mb-3">
<div class="float-start">
<b>Date:</b> 15 Feb 2024<br> <br><b>Place:</b> Raipur
</div>
<div class="float-end mt-3">
<b>Signature</b>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="ad-footer-btm">
<p><a href="">Terms of use</a> | <a href="">Privacy Policy</a> Copyright 2023 © VNR Seeds Pvt. Ltd India All Rights Reserved.</p>
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